A device looking for a purpose and user-centred co-design: 3D food printing not yet delivering on expectations of benefit for people with swallowing disability.
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Invited paper Bronwyn Hemsley1, Susan Balandin1,2, Stephen Dann3, Valerie Gay1, Emmanuel Josserand1, Tuck Wah Leong1 , Stuart Palmer4, and Katrina Skellern1 6th FOOD DRYING INTERNATIONAL CONFERENCE (FDIC 2020) 7th SYMPOSIUM FOR SPACE NUTRITION AND FOOD ENGINEERING, WUXI, CHINA 1,The University of Technology Sydney, Sydney, Australia. 2 Deakin University, Melbourne, Australia 3 Australian National University, Canberra, Australia 4 Own affiliation.
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A device looking for a purpose and user-centred co-design: 3D food printing not yet delivering on expectations of benefit for people with swallowing disability.
- 1. A device looking for a purpose and user-centred co-design: 3D food printing not yet delivering on expectations of benefit for people with swallowing disability. Bronwyn Hemsley1, Susan Balandin1,2, Stephen Dann3, Valerie Gay1, Emmanuel Josserand1, Tuck Wah Leong1 , Stuart Palmer4, and Katrina Skellern1 6th FOOD DRYING INTERNATIONAL CONFERENCE (FDIC 2020) 7th SYMPOSIUM FOR SPACE NUTRITION AND FOOD ENGINEERING, WUXI, CHINA 1,The University of Technology Sydney, Sydney, Australia. 2 Deakin University, Melbourne, Australia 3 Australian National University, Canberra, Australia 4 Own affiliation.
- 2. Acknowledgements • NHMRC Equipment Grant • ARC Discovery Grant 2020-2022 • ProtoSpace 3D Printing Lab UTS
- 3. Background • Estimates suggest that up to 8% of the world’s population have swallowing disability • Many will need texture-modified foods. Some will need pureed foods • The presentation of puree foods is problematic and could be improved using a range of strategies. • These strategies include food piping bags, food moulds, and 3D food printing of puree foods. Most foods currently printed are either standard texture (chocolate, biscuits) or pureed food (IDDSI Level 4).
- 5. Method 16 expert users across 11 disciplines had an 'immersion' experience in using a domestic scale 3D food printer in a research setting at ProtoSpace UTS. In 5 groups, they created puree food shapes, tasted the food printed, and discussed their impressions and ways that the printer might be used for people with swallowing disability.
- 6. 16 expert participants (11 disciplines) in 5 visits 3 speech pathologists 2 business managers 1 marketing and business 1 dietitian 1 manager disability services 1 direct support worker 1 public health 1 chef 1 computer scientist 1 engineer (human computer interaction) 1 chef/quality & safety officer 1 chef/catering manager 1 person with swallowing disability
- 7. Immersion in a 3D food printing experience • Interviews were transcribed and de- identified before experts provided feedback on a content thematic analysis undertaken by the authors. • Results are presented in terms of the themes identified across all 5 group discussions and transcripts of discussions during their immersion experiences. • Overall, there were 6 themes and 12 sub-themes identified in the data.
- 8. First Impressions and Experiences of 3D Food Printing Potential Applications of 3D Food Printing Usability of the 3D Food Printer Pre-processing of puree foods: Implications for using the 3D food printer Ideas for Improving 3D Food Printing Technologies Printer safety, errors and the consequences • Fun to do, but not meeting expectations and being insubstantial • Filling the capsules • Capsule parts and cleaning • The printer interface • Use in supported accommodation • Use in improving nutrition • Use as a novelty activity and improving choice and control. • Shapes of 3D printed foods • Diversity of food shapes and ingredients • Filling printer capsules and pre-filled capsules • Costs of the 3D food printer • Recipes for 3D food printing Sub-Themes Themes Sub-themes
- 9. “I’m not quite sure of what I envisaged cos I’ve seen 3D printing before but with seeing it with food it was very fiddly and time consuming.” G1P4 “It looks more like a dessert, a chocolate sort of thing. It doesn’t look like you can create a meal.” G1P2 “[people would be] frustrated because they wouldn’t see what they were expecting” G1P1 “I think it’s fantastic. This one I’m very proud of this.” G2P9
- 10. Conclusions The User Experience: Mind the Expectations Reality Gap Bring the reality closer to the consumer User-centred co-design is needed for an interactive device A device that listens to and responds to the user: Human computer interaction Puree food innovations are needed to assist the user in food cartridges Enabling success and safe food production Larger meals, detailed recipes, commercial supply
- 11. Program of “Transdisciplinary Tastes” research More than a meal, examining quality of life and food design for people with swallowing disability (Rebecca Smith, PhD Candidate, NHMRC Scholarship, UTS). Views of café owners and restauranteurs on 3D Food Printing for people with swallowing difficulties (Sarah Orlovich Master of Speech Pathology student) Designing a new user interface for 3D food printers to improve usability for dysphagia treatment (Elliot Jauregui, Bachelor of Engineering student capstone project) Twitter discussion relating to 3D food printing: influencers and expectations An Appetite for the Future Examining the views of adults with swallowing disability, family members, health professionals, residential care workers, chefs, kitchen staff Discovery Project 2020-2022 SURVEY NOW OPEN: https://www.surveymonkey.com/r/3DfoodCafes
- 12. Contact @BronwynHemsley @C3Dprintio https://c3dprintio.com/ Bronwyn.Hemsley@uts.edu.au SURVEY NOW OPEN: https://www.surveymonkey.com/r/3DfoodCafes
Editor's Notes
- 6th FOOD DRYING INTERNATIONAL CONFERENCE (FDIC 2020) 7th SYMPOSIUM FOR SPACE NUTRITION AND FOOD ENGINEERING WUXI, CHINA Title: A device looking for a purpose and user-centred co-design: 3D food printing not yet delivering on expectations of benefit for people with swallowing disability. Authors: Bronwyn Hemsley1, Susan Balandin1,2, Stephen Dann3, Valerie Gay1, Emmanuel Josserand1, Stuart Palmer4, Katrina Skellern1, and Tuck Wah Leong1. The University of Technology Sydney, Sydney, Australia. Deakin University, Melbourne, Australia Australian National University, Canberra, Australia Own affiliation. Abstract In this study, expert users were provided with an 'immersion' experience in using a domestic scale 3D food printer in a research setting to create puree food shapes, taste the food printed, and discuss their impressions and ways that the printer might be used for people with swallowing disability. With great anticipation and a keen sense of curiosity in the novelty of 3D food printing, participants were highly engaged but ultimately disappointed in what the 3D food printing afforded to them in terms of a food design and mealtime experience. Most users agreed that their expectations had far exceeded the reality experienced, and they were left wondering who might be able to use the device or indeed who it would help. Others wondered if 3D food printing could potentially provide some benefit in production of small-scale specialty food products such as treats and snacks, but acknowledged several logistical challenges in using the present technology in everyday supported accommodation settings. The results indicate that domestic-scale 3D food printers do not yet reflect rigorous use of user-centred co-design methods approaches to development, significantly limiting potential uptake and use across populations with swallowing disability and growth in the market. In this presentation we will present the results of the immersion experience and outline implications for future inclusive and user-centred co-design approaches in the development of 3D food printers intended to benefit people with swallowing disability.
- People who have dysphagia, or swallowing difficulty, may need texture-modified food that is easier to swallow (REFS). However, in residential care puree meals are often unattractive, the flavours are indistinguishable, and they may not be given safely. These issues reduce mealtime-related quality of life for people with (8 % of the population) for whom puree foods can reduce risk of choking (Cichero et al., 2017). 3D food printing technologies provide a potential solution to improve the visual appeal of these puree meals (Hemsley, Palmer, Kouzani, Adams, & Balandin, 2019). However, research on the development and implementation of 3D food printing to date has excluded engagement with people with swallowing difficulties, their supporters and key stakeholders in the provision of texture-modified foods to people with within this group (Hemsley, Palmer, et al., 2019). we need to decide swallowing disorders or swallowing difficulties/disability and stick with the one term throughout (
- In a recent systematic review of the literature on 3D printed foods for people with swallowing disability, Hemsley, Palmer, et al. (2019) concluded that research to date primarily addresses the ‘constructive’ problems of 3D printing food (e.g., ways to expand the range of nutritious foods that could be printed, including grains, meat, vegetable, and fruit), with little attention to empirical or conceptual questions about human interactions with 3D food printers, or their views and experiences of using these devices. Research on the development of appropriate business models for implementing such solutions and their associated costs to different stakeholders along the value chain, including safety for users with or without swallowing disorders, is also absent in the literature. Furthermore, although human computer interaction is an integral part of 3D food printing (Hemsley, Palmer, et al., 2019), no studies have examined (a) the usability of 3D food printers, especially the use by older people or people with swallowing difficulties or their supporters, (b) how 3D food printers would be used by the people who are expected to benefit the most; or (c) the safety of 3D printed food.
- The 3D Food Printer used in this study, the ‘Foodini’ by Natural Machines, is powered by Android and features computer aided design (CAD) capabilities (Natural Machines, 2019). In this study, the device was housed and used at the University in a laboratory setting. The Foodini is an extrusion-based printer with 5 stainless steel capsules that the user fills with pre-processed puree food (see Figure 1 for example puree food shapes created using Foodini). In this study, pureed foods were either purchased ready-made or made by cooking raw vegetables, meat, or fruit and using a domestic-scale food processor to puree these. The range of pre-made purees (e.g. packaged icing mix, mashed potato, guacamole or homus dip) were identified as ingredients on the food menu of the Foodini printer and used as food substrates for the test prints, and. Each puree food used in the printer was first tested to ensure it was of a smooth puree consistency meeting the standards of the International Dysphagia Diet Standardization Initiative (IDDSI )Fork Test (https://iddsi.org.
- With great anticipation and a keen sense of curiosity in the novelty of 3D food printing, participants were highly engaged but ultimately disappointed in what the 3D food printing afforded to them in terms of a food design and mealtime experience. Most users agreed that their expectations had far exceeded the reality experienced, and they were left wondering who might be able to use the device or indeed who it would help. The results indicate that domestic-scale 3D food printers do not yet reflect rigorous use of user-centred co-design methods approaches to development, significantly limiting potential uptake and use across populations with swallowing disability and growth in the market. Others wondered if 3D food printing could potentially provide some benefit in production of small-scale specialty food products such as treats and snacks, but acknowledged several logistical challenges in using the present technology in everyday supported accommodation settings.
- There is a substantial gap between user expectations and the reality of the experience in using 3D printers to create puree food shapes. Usability and the human computer interaction elements of the 3D food printer are low and need to be designed with users. User-centred co-design is now needed to create 3D food printers that are responsive, interactive, easy to use, deliver larger meals, a wider variety of pre-programmed shapes, detailed food recipes. Other innovations in the commercial supply of Level 4 IDDSI food materials for printing, or pre-filled printed cartridges, may increase usability and feasibility. Lack of familiarity and exposure to 3D food printing, along with its usability, will limit its uptake and use in populations with swallowing disability.